1
|
Brasileiro J, Widman L, Hurst JL. Sexual self-efficacy and sexual communication among adolescent girls: moderated mediation results from a randomized controlled trial. Psychol Health 2023; 38:1273-1287. [PMID: 34905990 PMCID: PMC9210825 DOI: 10.1080/08870446.2021.2012573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 10/28/2021] [Accepted: 11/25/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Guided by the Operating Conditions Framework, the goal of this study was to identify how and for whom an online sexual health program called Health Education and Relationship Training (HEART) worked. DESIGN Data come from a randomized controlled trial among 198 U.S. high school girls who completed HEART or an attention-matched control. We conducted mediation and moderated mediation models to determine if sexual self-efficacy was a mediator and if program acceptability and sexual activity status were moderators of HEART efficacy. MAIN OUTCOME MEASURE Sexual communication skills were assessed with a behavioral role-play task. RESULTS HEART significantly improved sexual communication skills. These effects were fully mediated through sexual self-efficacy. Specifically, HEART improved sexual self-efficacy which in turn increased sexual communication skills. Also, when participants liked the program more, the effect of HEART on sexual self-efficacy was stronger. Further, among girls who had engaged in sexual activity, sexual self-efficacy was significantly associated with sexual communication skills. CONCLUSION This study provides insights into the mechanisms of behavior change underlying HEART. Results highlight the need to further 'unpack' the effects of other sexual health programs, as we showed that programs may work better under certain conditions.
Collapse
Affiliation(s)
- Julia Brasileiro
- Department of Psychology, North Carolina State University, Raleigh, USA
| | - Laura Widman
- Department of Psychology, North Carolina State University, Raleigh, USA
| | - Jeffrey L Hurst
- Department of Psychology, North Carolina State University, Raleigh, USA
| |
Collapse
|
2
|
Opara I. Examining African American Parent-Daughter HIV Risk Communication Using a Black Feminist-Ecological Lens: Implications for Intervention. JOURNAL OF BLACK STUDIES 2018; 49:134-151. [PMID: 31341331 PMCID: PMC6655422 DOI: 10.1177/0021934717741900] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Using a framework of ecological systems theory and Black feminist theory, this article provides a conceptual exploration of barriers and facilitators to HIV risk communication between African American parents and daughters. African American female adolescents are disproportionately diagnosed with sexually transmitted diseases (STDs) and are more likely to engage in sexually risky behaviors, which increases their risk of contracting HIV. Researchers have documented the importance of parental beliefs, knowledge, and communication about sexual and HIV risk as a protective factor in influencing safe sexual behavior in their daughters. By incorporating the ecological influences that affect familial processes among African American parents, in addition to highlighting Black feminist concepts, this article proposes a racial and gender-specific theoretical model to guide future family-based HIV prevention interventions.
Collapse
|
3
|
Shegog R, Craig Rushing S, Gorman G, Jessen C, Torres J, Lane TL, Gaston A, Revels TK, Williamson J, Peskin MF, D'Cruz J, Tortolero S, Markham CM. NATIVE-It's Your Game: Adapting a Technology-Based Sexual Health Curriculum for American Indian and Alaska Native youth. J Prim Prev 2017; 38:27-48. [PMID: 27520459 DOI: 10.1007/s10935-016-0440-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Sexually transmitted infection (STI) and birth rates among American Indian/Alaska Native (AI/AN) youth indicate a need for effective middle school HIV/STI and pregnancy prevention curricula to delay, or mitigate, the consequences of early sexual activity. While effective curricula exist, there is a dearth of curricula with content salient to AI/AN youth. Further, there is a lack of sexual health curricula that take advantage of the motivational appeal, reach, and fidelity of communication technology for this population, who are sophisticated technology users. We describe the adaptation process used to develop Native It's Your Game, a stand-alone 13-lesson Internet-based sexual health life-skills curriculum adapted from an existing promising sexual health curriculum, It's Your Game-Tech (IYG-Tech). The adaptation included three phases: (1) pre-adaptation needs assessment and IYG-Tech usability testing; (2) adaptation, including design document development, prototype programming, and alpha testing; and (3) post-adaption usability testing. Laboratory- and school-based tests with AI/AN middle school youth demonstrated high ratings on usability parameters. Youth rated the Native IYG lessons favorably in meeting the needs of AI/AN youth (54-86 % agreement across lessons) and in comparison to other learning channels (57-100 %) and rated the lessons as helpful in making better health choices (73-100 %). Tribal stakeholders rated Native IYG favorably, and suggested it was culturally appropriate for AI/AN youth and suitable for implementation in tribal settings. Further efficacy testing is indicated for Native IYG, as a potential strategy to deliver HIV/STI and pregnancy prevention to traditionally underserved AI/AN middle school youth.
Collapse
Affiliation(s)
- Ross Shegog
- Center for Health Promotion and Prevention Research, The University of Texas School of Public Health, The University of Texas Health Science Center Houston, 7000 Fannin Street, Suite 2668, Houston, TX, 77030, USA.
| | - Stephanie Craig Rushing
- Northwest Portland Area Indian Health Board, 2121 SW Broadway, Suite 300, Portland, OR, 97201, USA
| | - Gwenda Gorman
- Inter Tribal Council of Arizona, Inc., 2214 North Central Avenue, Suite 100, Phoenix, AZ, 85004, USA
| | - Cornelia Jessen
- Division of Community Health Services, Alaska Native Tribal Health Consortium, 3900 Ambassador Drive, Anchorage, AK, 99508, USA
| | - Jennifer Torres
- Center for Health Promotion and Prevention Research, The University of Texas School of Public Health, The University of Texas Health Science Center Houston, 7000 Fannin Street, Suite 2668, Houston, TX, 77030, USA
| | - Travis L Lane
- Inter Tribal Council of Arizona, Inc., 2214 North Central Avenue, Suite 100, Phoenix, AZ, 85004, USA
| | - Amanda Gaston
- Northwest Portland Area Indian Health Board, 2121 SW Broadway, Suite 300, Portland, OR, 97201, USA
| | - Taija Koogei Revels
- Division of Community Health Services, Alaska Native Tribal Health Consortium, 3900 Ambassador Drive, Anchorage, AK, 99508, USA
| | - Jennifer Williamson
- Division of Community Health Services, Alaska Native Tribal Health Consortium, 3900 Ambassador Drive, Anchorage, AK, 99508, USA
| | - Melissa F Peskin
- Center for Health Promotion and Prevention Research, The University of Texas School of Public Health, The University of Texas Health Science Center Houston, 7000 Fannin Street, Suite 2668, Houston, TX, 77030, USA
| | - Jina D'Cruz
- Center for Disease Control (CDC), Office of Public Health Scientific Services (OPHSS), Center for Surveillance, Epidemiology and Laboratory Services (CSELS), Dekalb County, Atlanta, GA, USA
| | - Susan Tortolero
- Center for Health Promotion and Prevention Research, The University of Texas School of Public Health, The University of Texas Health Science Center Houston, 7000 Fannin Street, Suite 2668, Houston, TX, 77030, USA
| | - Christine M Markham
- Center for Health Promotion and Prevention Research, The University of Texas School of Public Health, The University of Texas Health Science Center Houston, 7000 Fannin Street, Suite 2668, Houston, TX, 77030, USA
| |
Collapse
|
4
|
Rink E, FourStar K, Anastario MP. The Relationship Between Pregnancy Prevention and STI/HIV Prevention and Sexual Risk Behavior Among American Indian Men. J Rural Health 2015; 33:50-61. [PMID: 26696246 DOI: 10.1111/jrh.12166] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2015] [Indexed: 11/27/2022]
Abstract
OBJECTIVE We examined the relationship between American Indian men's attitudes toward pregnancy prevention, STI/HIV prevention, and sexual risk behavior. Attention was given to: (1) attitudes and intentions to use condoms and sexual risk behavior; (2) STI/HIV prevention characteristics and sexual risk behavior; (3) attitudes toward abstinence and monogamy and sexual risk behavior; and (4) decision-making in relationships and sexual risk behavior. STUDY DESIGN Our sample included 120 heterosexual American Indian men aged 18 to 24 living on a reservation. Data were collected during in-depth interviews. A community-based participatory research framework was used to ensure the relevancy and acceptability of the study given the sensitivity of the topic. PRINCIPAL FINDINGS Results demonstrated that attitudinal factors were associated with sexual risk behavior, particularly inconsistent condom use. Attitudes associated with consistent condom use suggested greater levels of positive dispositions toward prevention and intention to use condoms. Consistent condom use was associated with more cautious attitudes toward sex with multiple sex partners. Study results suggested that American Indian men who reported sex with multiple partners exhibited a set of attitudes and beliefs toward pregnancy prevention and STI/HIV prevention that corresponded with a disposition resulting from their behaviors, in that engaging in sexual risk behavior elevated their levels of risk perception. CONCLUSIONS Our findings suggest that heterosexual American Indian men living in rural environments need sexual and reproductive health programs and clinical services that address differing attitudes toward condom use within the context of multiple sex partners and sexual risk behavior.
Collapse
Affiliation(s)
- Elizabeth Rink
- Department of Health and Human Development, Montana State University, Bozeman, Montana
| | - Kristofer FourStar
- School of Public and Community Health Sciences, University of Montana, Missoula, Montana
| | | |
Collapse
|
6
|
Croy CD, Mitchell CM, Bezdek M, Spicer P. Young Adult Migration from a Northern Plains Indian Reservation: Who Stays and Who Leaves. POPULATION RESEARCH AND POLICY REVIEW 2009; 28:641-660. [PMID: 20161560 DOI: 10.1007/s11113-008-9123-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
We evaluated how ambitions, community ties, monetary sufficiency, employment, and alcohol consumption related to whether young American Indian adults had moved from their Northern Plains reservation. Of 518 Northern Plains reservation residents in 1993, we located 472 in 2003-2005 and found that 89 lived more than a four-hour drive from the reservation. Coding the 472 as to whether they had stayed on/near the reservation or moved away, we ran logistic regressions on data they reported in 1996 to determine which demographic and attitudinal variables were associated with having moved. We found ambitions and goals were more associated with moving away than were ties to the community, which in turn were more related than monetary and personal characteristics that promote independence and prosperity. The more importance they placed on getting a good education or carrying on the tribe's traditions, the more likely they were to have moved away. We found too that the odds of moving away decreased with greater alcohol consumption. Tribal council members and college administrators therefore may wish to promote policies that increase opportunities for young adults to achieve higher education goals while remaining on reservation to carry on tribal traditions. Benefits may also come from encouraging and assisting reservation members studying off-reservation to return after completing their education. These findings would argue too for greater investment in alcohol services for reservation-dwelling populations.
Collapse
|
7
|
Rostosky SS, Dekhtyar O, Cupp PK, Anderman EM. Sexual self-concept and sexual self-efficacy in adolescents: a possible clue to promoting sexual health? JOURNAL OF SEX RESEARCH 2008; 45:277-286. [PMID: 18686156 DOI: 10.1080/00224490802204480] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
This study examined the associations between sexual self-concept (sexual esteem and sexual anxiety) and sexual self-efficacy (situational and resistive) in a sample of 388 high school students (59% Caucasian, 28% African American). Males reported lower sexual esteem and lower sexual self-efficacy than females. Males and African Americans reported higher levels of sexual anxiety and lower levels of resistive self-efficacy than females and Caucasians. In regression models, higher sexual self-esteem uniquely predicted higher sexual self-efficacy scores, even after controlling for demographic variables, knowledge of sexual risk, and previous coital experience. In post hoc analyses, sexual self-esteem mediated the relation between knowledge of sexual risk and both types of sexual self-efficacy. Results suggest the need for interventions to promote male sexual self-efficacy and sexual esteem and the need for longitudinal research that explicates models of sexual health in adolescence.
Collapse
Affiliation(s)
- Sharon Scales Rostosky
- Department of Education and Counseling Psychology, University of Kentucky, Lexington, KY 40506-0017, USA.
| | | | | | | |
Collapse
|
8
|
Kaufman CE, Desserich J, Big Crow CK, Holy Rock B, Keane E, Mitchell CM. Culture, context, and sexual risk among Northern Plains American Indian Youth. Soc Sci Med 2007; 64:2152-64. [PMID: 17379373 PMCID: PMC2099307 DOI: 10.1016/j.socscimed.2007.02.003] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2005] [Indexed: 11/26/2022]
Abstract
American Indian adolescents have two to four times the rate of sexually transmitted diseases (STDs) compared to whites nationally, they shoulder twice the proportion of AIDS compared to their national counterparts, and they have a 25% higher level of teen births. Yet little is known about the contemporary expectations, pressures, and norms that influence American Indian youth or how those might be shaped by today's lived cultural experiences, which frustrates attempts to mitigate the apparent disparity in sexual health. This paper used data from focus groups, in-depth interviews, and surveys with American Indian adolescents and young male and female adults from a Northern Plains tribe to contextualize sexual risk (and avoidance). Placing the findings within an adapted indigenist stress-coping framework, we found that youth faced intense pressures for early sex, often associated with substance use. Condoms were not associated with stigma, yet few seemed to value their importance for disease prevention. Youth encountered few economic or social recriminations for a teen birth. As such, cultural influences are important to American Indian sexual health and could be a key part of prevention strategies.
Collapse
Affiliation(s)
- Carol E Kaufman
- American Indian and Alaska Native Programs, University of Colorado at Denver and Health Sciences Center, Aurora, CO 80045, USA.
| | | | | | | | | | | |
Collapse
|
9
|
Devries KM, Free C, Jategaonkar N. Factors associated with condom use among Aboriginal people: a systematic review. Canadian Journal of Public Health 2007. [PMID: 17278678 DOI: 10.1007/bf03405385] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To review evidence on factors associated with condom use among Aboriginal people and the methodological quality of studies assessing these factors. METHODS A systematic review of published and unpublished literature was undertaken. Searches of databases and indexes were performed and authors were contacted directly. Studies reporting on associations between any independent variables and a condom use outcome were included. Data on the quality of each study was extracted, and the strength of evidence for associations between risk factors and condom use outcomes was assessed by counting the number of studies and sample size of each study. RESULTS Searches yielded 17 analyses on 10 independent samples that met the inclusion criteria. Most studies were cross-sectional and utilized small non-representative samples. Some evidence for a negative association between condom use and having a steady partner emerged; and a negative association between White male/Alaska Native female sex partner pairs was found. Evidence was insufficient to judge associations between other risk factors and condom use. CONCLUSIONS The quality and quantity of evidence regarding the predictors of condom use in Aboriginal populations is limited. A concerted effort in primary research on facilitators of and barriers to condom use which are specific to and appropriate for Aboriginal people is needed to inform effective condom promotion interventions for Aboriginal communities.
Collapse
|